Clinical decision support tools: personal digital assistant versus online dietary supplement databases.
BACKGROUND
Clinical decision support tools (CDSTs) on personal digital assistants (PDAs) and online databases assist healthcare practitioners who make decisions about dietary supplements.


OBJECTIVE
To assess and compare the content of PDA dietary supplement databases and their online counterparts used as CDSTs.


METHODS
A total of 102 question-and-answer pairs were developed within 10 weighted categories of the most clinically relevant aspects of dietary supplement therapy. PDA versions of AltMedDex, Lexi-Natural, Natural Medicines Comprehensive Database, and Natural Standard and their online counterparts were assessed by scope (percent of correct answers present), completeness (3-point scale), ease of use, and a composite score integrating all 3 criteria. Descriptive statistics and inferential statistics, including a chi(2) test, Scheffé's multiple comparison test, McNemar's test, and the Wilcoxon signed rank test were used to analyze data.


RESULTS
The scope scores for PDA databases were: Natural Medicines Comprehensive Database 84.3%, Natural Standard 58.8%, Lexi-Natural 50.0%, and AltMedDex 36.3%, with Natural Medicines Comprehensive Database statistically superior (p < 0.01). Completeness scores were: Natural Medicines Comprehensive Database 78.4%, Natural Standard 51.0%, Lexi-Natural 43.5%, and AltMedDex 29.7%. Lexi-Natural was superior in ease of use (p < 0.01). Composite scores for PDA databases were: Natural Medicines Comprehensive Database 79.3, Natural Standard 53.0, Lexi-Natural 48.0, and AltMedDex 32.5, with Natural Medicines Comprehensive Database superior (p < 0.01). There was no difference between the scope for PDA and online database pairs with Lexi-Natural (50.0% and 53.9%, respectively) or Natural Medicines Comprehensive Database (84.3% and 84.3%, respectively) (p > 0.05), whereas differences existed for AltMedDex (36.3% vs 74.5%, respectively) and Natural Standard (58.8% vs 80.4%, respectively) (p < 0.01). For composite scores, AltMedDex and Natural Standard online were better than their PDA counterparts (p < 0.01).


CONCLUSIONS
Natural Medicines Comprehensive Database achieved significantly higher scope, completeness, and composite scores compared with other dietary supplement PDA CDSTs in this study. There was no difference between the PDA and online databases for Lexi-Natural and Natural Medicines Comprehensive Database, whereas online versions of AltMedDex and Natural Standard were significantly better than their PDA counterparts.
Clauson
Kevin A
KA
Pharmacy Practice, College of Pharmacy-West Palm Beach, Nova Southeastern University, Palm Beach Gardens, FL 33410, USA. clauson@nova.edu
Polen
Hyla H
HH
Peak
Amy S
AS
Marsh
Wallace A
WA
DiScala
Sandra L
SL
D034201:Computers, Handheld; D016208:Databases, Factual; D003657:Decision Making; D020000:Decision Support Systems, Clinical / Q000458:organization & administration; D019587:Dietary Supplements / Q000592:standards*; D004346:Drug Information Services / Q000458:organization & administration; D004347:Drug Interactions; D006801:Humans; D020407:Internet; D008903:Minerals; D028321:Plant Preparations; D014815:Vitamins
D008903:Minerals; D028321:Plant Preparations; D014815:Vitamins